缺血性脑血管病患者血浆Hcy水平与颈动脉粥样硬化斑块的相关性研究  

Correlation between Plasma Hcy Level and Carotid Atherosclerotic Plaque in Patients with Ischemic Cerebrovascular Disease

作　　者：陈莹[1] 吴艳婷 范丽娟[1] 胡允兆[1] 卢剑华[1] 黄裕立[1] 吕伟标[1] CHEN Ying;WU Yan-ting;FAN Li-juan;HU Yun-zhao;LU Jian-hua;HUANG Yu-li;LYU Wei-biao(Department of Cardiology,Shunde Hospital,Southern Medical University,Shunde,Guangdong Province,528300 China)

机构地区：[1]南方医科大学附属顺德医院心内科,广东顺德528300

出　　处：《世界复合医学》2018年第3期14-17,共4页World Journal of Complex Medicine

基　　金：佛山市医学类科技攻关项目(2015AB002183)

摘　　要：目的研究缺血性脑血管病患者(ICVD)血浆同型半胱氨酸(Hcy)水平与颈动脉粥样硬化(AS)斑块的关系。方法选取2015年7月—2017年6月佛山市南方医科大学附属顺德医院收治268例ICVD患者为该次的研究对象,通过问卷采集患者的临床资料;采用彩色多普勒超声仪检测颈动脉内-中膜厚度及斑块(AS)性质;用酶联免疫法检测血浆Hcy浓度,用全自动生化分析仪对甘油三酯、胆固醇等血清生化指标进行检测。结果根据AS病变程度不同的3组患者的血浆高同型半胱氨酸(HHcy)血症发生率比较,斑块形成组(70.13%)高于增厚组(63.64%),高于正常组(37.04%),差异有统计学意义(χ~2=24.380,P=0.001);血浆Hcy浓度比较,斑块形成组(27.8μmol/L)高于增厚组(21.7μmol/L),高于正常组(12.9μmol/L),差异有统计学意义(H=7.05,P=0.001)。多因素Logistic回归分析显示,血浆HHcy是AS形成的独立危险因素(Waldχ~2=4.956,P=0.031)。结论血浆Hcy水平与颈动脉粥样硬化病变程度及斑块的易损性相关,并呈现正相关关系,血浆HHcy是形成颈动脉粥样硬化的独立危险因素。Objective To study the relationship between plasma homocysteine（Hcy） level and carotid atherosclerosis（AS） plaque in patients with ischemic cerebrovascular disease（ICVD）. Methods From July 2015 to June 2017, 268 ICVD patients admitted to Shunde Hospital of Southern Medical University of Foshan City were selected for the study. The clinical data of the patients were collected through questionnaires. The carotid artery was detected by color Doppler ultrasound. Endo-media thickness and plaque（AS） properties; plasma Hcy concentration was detected by enzyme-linked immunosorbent assay, and serum biochemical indicators such as triglyceride and cholesterol were detected by an automatic biochemical analyzer. Results According to the incidence of plasma homocysteine（HHcy）emia in the three groups with different AS lesions, the plaque formation group（70.13%） was higher than the thickening group（63.64%）, higher than the normal group（37.04%）, the difference was statistically significant（χ^2=24.380, P=0.001）; plasma Hcy concentration was higher in the plaque formation group（27.8 μmol/L） than in the thickening group（21.7 μmol/L）, higher than the normal group（12.9 μmol/L）, the difference was statistically significant（H=7.05, P=0.001）. Multivariate logistic regression analysis showed that plasma HHcy was an independent risk factor for AS formation（Waldχ^2=4.956, P=0.031）. Conclusion Plasma Hcy levels are associated with carotid atherosclerotic lesions and plaque vulnerability, and there is a positive correlation. Plasma HHcy is an independent risk factor for carotid atherosclerosis.

关 键 词：脑缺血 同型半胱氨酸 颈动脉粥样硬化 斑块 

分 类 号：R743[医药卫生—神经病学与精神病学]